Full-Thickness Skin Grafts Have Superior Cosmetic Outcome

In horses requiring skin grafts to enhance wound healing, split-thickness grafts are typically used, according to Ferenc Toth, DVM, PhD, of the University of Tennessee in Knoxville; however, full-thickness grafts provide a better cosmetic appearance, which is why they usually are used to cover human facial wounds.

If a horse has a wound, the body tries to repair the damage by forming granulation tissue to cover the wound, leading to a scar. A skin graft lessens the scarring.

A full-thickness skin graft contains the epidermis (outer layer of the skin) and the entire dermis (the layer just under the epidermis), while a split-thickness skin graft contains the epidermis and only part of the dermis.

Another advantage to full-thickness skin grafting in horses is that "the whole grafting procedure (i.e., harvesting and implantation of the graft) can be performed with the horse standing, using sedation and local or regional analgesia, obviating the need for general anesthesia," he said.

A wound on the lower portion of a limb can look better and heal faster if a full-thickness skin graft is applied to it than if the wound is just cleansed daily and bandaged.

In addition, a full-thickness graft can be used to cover wounds created during the removal of a tumor, allowing a veterinarian to remove more tissue around the tumor, decreasing the likelihood it will recur.

In a recent study, full-thickness grafts were applied to wounds of six adult horses--three that required the removal of a cutaneous tumor and three that had limb lacerations. Full-thickness skin grafts were harvested from the skin over the cranial pectoral muscles.

Grafts were completely accepted in five horses, but only 30% of the graft was accepted in one horse, leaving a large scar.

"If a wound is small and fresh, and if excellent cosmetic outcome is desired, I would apply a full-thickness skin graft," Toth said.

However, a full thickness graft cannot be used on a large wound because the veterinarian would need to remove too much skin from the harvest site.

The study "Full-thickness skin grafting to cover equine wounds caused by laceration or tumor resection" was published May 2010 online ahead of print in Veterinary Surgery.

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